ACIVS 2023 Registration Form
Advanced Concepts for Intelligent Vision Systems 2023
Please print the form, fill it in and send the scanned version to acivs23@gmail.com

General Information
Last Name:  	
First Name:  	
Title (Prof./Dr./Mr./Ms.): 	
Affiliation:	
Postal Address:	
City Province/State: 	
Postal Code: 	
Telephone, Fax: 	
E-mail Address: 	
Invoice data
Institution name and address, as on invoice (if other than the affiliation above)

		
Registration fees
Please check a box (please note that at least one author of an accepted paper must register at the REGULAR rate even if the author is a student) and your preferred currency for payment:
		Before 07 July	From 08 July	
	Regular – No IEEE Member	650  EUR/1,150 NZD/100,000 JPY
	700 EUR/1,230 NZD/110,000 JPY	
	Regular - IEEE Member	600  EUR/1,050 NZD/
95,000 JPY	700 EUR/1,230 NZD/110,000 JPY	
	Student (student ID required)	400  EUR/700 NZD/
62,000 JPY	450 EUR/800 NZD/70,000 JPY	

Papers
Papers ID number(s): 	
Note that the registration fee covers only one paper and one attendee. If you are registering more papers, please pay 250EUR for each additional paper. 
Number (and ID) of additional papers:	
Additional fees
Extra ticket for social events (welcoming reception, banquet, castle tour):	Number of tickets ______x130 EUR/230 NZD/20,000 JPY	

Total amount of payment
Total amount of payment: 	EUR/NZD/JPY
Method of payment
The total fee should be paid: 
- Using PAYPAL (You may need a credit card if you do not have a paypal account). Note that additional paypal fees will apply
We will email back to you a paypal payment link once we receive this form completed.